The form of home automation called assistive domotics focuses on making it possible for the elderly and disabled to remain at home, safe and comfortable. Home automation is becoming a viable option for the elderly and disabled who would prefer to stay in the comfort of their homes rather than move to a healthcare facility. This field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards the elderly and disabled.

While talking about technology, Microsoft Corporation’s C.E.O. Steve Ballmer once said, “The number one benefit of technology is that it empowers people to do what they want to do. It lets people be creative. It lets people be productive. It lets people learn things they didn't think they could learn before, and so in a sense it is all about potential” (BrainyQuote 2007). Similarly, through new technology, a little creativity, and a lot of thinking, we have begun to produce home automation systems that make it possible for the elderly and disabled to live by themselves and meet their potential. Due to the aging population of the United States, measures must be taken in order to provide health care to the elderly. The US Census Bureau has projected that by 2010 13% of the population will be 65 or older (Cheek 2005). The bureau has also projected that by 2030 there will be 9 million Americans older than 85 (Cheek 2005). The aging population has generated a significant interest by the government, as well as industry leaders, to develop home automation systems for the elderly. Due to the drastic increases in health-care facility costs, more and more elderly people are turning to home automation, a concept also known as "smart homes", to allow them to age in the comfort of their own homes. These systems make normal Activities of Daily Living (ADL) possible for the elderly and disabled who would otherwise not be able to live on their own. Smart homes can most easily be described as “a collective term for information and communication technology in homes where components communicate through a local network” (Cheek 2005).

There are two basic forms of home automation systems for the elderly: embedded health systems and private health networks. Embedded health systems integrate sensors and microprocessors in appliances, furniture, and clothing which collect data that is analyzed and can be used to diagnose diseases and recognize risk patterns. Private health networks implement wireless technology to connect portable devices and store data in a household health database. Due to the need for more healthcare options for the aging population “there is a significant interest from industry and policy makers in developing these technologies” (Eriksson 2002).

Home automation is being implemented into more and more homes of the elderly and disabled in order to maintain their independence and safety. These smart homes allow the elderly and disabled to stay in their homes where they feel comfortable, instead of moving to a costly health care facility. The transition to a health care facility can cause a lot of anxiety and home automation can either prevent or delay this anxiety (Cheek 2005). For the disabled smart homes give them opportunity for independence, which will help them gain confidence and determination. Smart homes can provide both the elderly and disabled with many different types of emergency assistance systems, security features, fall prevention, automated timers, and alerts. These systems allow for the individual to feel secure in their homes knowing that help is only minutes away. Smart home systems will make it possible for family members to monitor their loved ones from anywhere with an internet connection.

Home automation for healthcare can range from very simple alerts to lavish computer controlled network interfaces. Some of the monitoring or safety devices that can be installed in a home include lighting and motion sensors, environmental controls, video cameras, automated timers, emergency assistance systems, and alerts.

The University of Florida has built a 500-square-foot (46 m2) smart house that is designed to assist and to provide medical care to "Matilda", a life size mannequin (Ascribe 2003). The house implements devices including “a microwave that recognizes entrees and automatically determines how long to cook them” (Ascribe 2003) and devices to track the individuals location within the home. The house also uses devices to detect water on the floor and a camera that allows the person to view who is at the door and let them in using a cell phone. The smart house at the University of Florida relies on a centralized computer network to deliver electronically coordinated assistance” (Ascribe 2003)*.

In order to maintain the security of the home many home automation systems integrate features such as remote keyless entry systems which will allow seniors to view who is at the door and then remotely open the door. Home networks can also be programmed to automatically lock doors and shut blinds in order to maintain privacy.

These simple systems and tools include personal alarm systems and emergency response telephones that do not have to be integrated into a smart home system (Celler 1999). A typical system consists of a small wireless pendant transceiver to be worn around the neck or wrist. The system has a central unit plugged into a telephone jack, with a loudspeaker and microphone. When the pendant is activated a 24-hour control center is contacted. Generally the 24 hour control center speaks to the user and identifies that help is required e.g. Emergency services are dispatched. The control center also has information of the user, e.g. medical symptoms, medication allergies, etc. The unit has a built in rechargeable battery backup and the ability to notify the control center if the battery is running low or if the system loses power. Modern systems have active wireless pendants that are polled frequently advising battery, and signal strength status as older style pendant could have a battery that has failed rendering the pendant useless when required in an emergency.

These systems and tools generate alarms and alerts automatically if significant changes are observed in the user's vital signs (Celler 1999). These systems are usually fully integrated into a home network and allow health professionals to monitor patients at home. The system consists of an antenna that a patient holds over their implanted cardiac device to transmit data for downloading over the telephone line and viewing by the patient’s physician. The collected data can be accessed by the patient or family members. Another example of this type of system is a Smart Shirt that measures heart rate, electrocardiogram results, respiration, temperature and other vital functions and alerts the patient or physician if there is a problem (Bowie 2000).

These types of systems would help the elderly and disabled deal with loneliness and depression by connecting them with other elderly or disabled individuals through the Internet, reducing their sense of isolation (Celler 1999).

Home automation systems may include automatic reminder systems for the elderly (Cheek 2005). Such systems are connected to the Internet and make announcements over an intercom. They can prompt about doctor’s appointments and taking medicine, as well as everyday activities such as turning off the stove, closing the blinds, locking doors, etc. Users choose what activities to be reminded of. The system can be set up to automatically perform tasks based on user activity, such as turning on the lights or adjusting room temperature when the user enters specified areas. Other systems can remind users at home or away from home to take their medicine, and how much, by using an alarm wristwatch with text message and medical alert. Reminder systems can also remind about everyday tasks such as eating lunch or walking the dog.

Some communities offer free telephone reassurance services [1] to residents, which includes both safety check calls as well as reminders. These services have been credited with saving the lives of many elderly and senior citizens who choose to remain at home.[2]

Smart homes can implement medication dispensing devices in order to ensure that necessary medications are taken at appropriate times (Cheek 2005). Automated pill dispensers can dispense only the pills that are to be taken at that time and are locked; versions are available for Alzheimer’s patients that have a lock on them (Cheek 2005). For diabetic patients a talking glucose monitor allows the patient to check their blood sugar level and take the appropriate injection (Cheek 2005). Digital thermometers are able to recognize a fever and alert physicians. Blood pressure and pulse monitors dispense hypertensivemedications when needed.

Domestic robots, connected to the domotic network, are included to perform or help in household chores. Dedicated robots included robots helping to administer medications and alerting a remote caregiver if the patient is about to miss his or her medicine dose (oral or no-oral medications).

The Care-Providing robot FRIEND developed at the Institute of Automation (IAT) of the University of Bremen is a semi-autonomous robot designed to support disabled and elderly people in their daily life activities, like preparing and serving a meal, or reintegration in professional life.

The recent advances made in tailoring home automation toward the elderly have generated opposition. It has been stated that “Smart home technology will be helpful only if it is tailored to meet the individual needs of each patient” (Cheek 2005). This currently creates a problem because many of the interfaces designed for home automation “are not designed to take functional limitations, associated with age, into consideration” (Cheek 2005). Another problem that has been presented involves making the system user-friendly for the elderly who often have difficulty operating electronic devices. The cost of the systems has also presented a challenge, because although the systems would be cheaper than the costs of a long-term health care facility, the U.S. government currently provides no assistance to seniors who choose to install these systems (in some countries such as Spain the Dependency Law includes this assistance).

The biggest concern expressed by potential users of smart home technology is "fear of lack of human responders or the possible replacement of human caregivers by technology" (Cheek 2005), but home automation should be seen as something that augments, but does not replace, human care.